Characterization of Dronabinol Usage in a Pediatric Oncology Population

Abstract

Objectives: Chemotherapy-induced nausea and vomiting (CINV) remains an important side effect associated with administration of chemotherapy in pediatrics. The aim of this study was to retrospectively review dronabinol use in a pediatric cancer center, with the intent of characterizing its use and identifying trends such as age, sex, diagnosis, and chemotherapy that describe where dronabinol is best used as an adjuvant antiemetic.

Methods: Patients receiving dronabinol at Riley Hospital for Children between 2000 and 2010 were identified. Patients eligible for inclusion were those with malignancy ≤18 years old, who received at least 1 dose of dronabinol for CINV during admission.

Results: Ninety-five percent of patients received moderate or highly emetogenic chemotherapy. When dronabinol doses were analyzed, 95% of patients received doses that were lower than reference guidelines, 55% received dronabinol as a scheduled medication, and 19% received dronabinol 1 to 3 hours before chemotherapy. Overall, 60% of patients had a defined positive response to dronabinol. Sixty-five percent of patients received repeat courses of dronabinol, and 62% received outpatient prescriptions for dronabinol.

Conclusions: Dronabinol appears to be a viable option as an adjuvant antiemetic in pediatric CINV, but a prospective trial using patients as their own controls is necessary to truly define dronabinol's place in therapy.

Keywords: chemotherapy; dronabinol; nausea; pediatric; vomiting.

Figure.

Response to dronabinol based on chemotherapy emetogenicity. = highly emetogenic; = moderately emetogenic.